DAILY MEAL ORDER/INVOICE



DAILY MEAL ORDER/INVOICE

MOBILE FOOD SERVICES | 1. Contract Number

AG-024B-05-9017 |2. Invoice Date

06/15/05 |3. Mobile Food Service Unit ID No.

K-1 |4. Invoice No.

1 | |

| | 5. Incident Name |6. Job Code | 7. Resource Order No. / Request No. |8. Benefiting Unit, Region / Agency |

| |Big Bad Fire |P6BKIB |OR-SIF-000011 E-7 |Wenatchee NF/R6/USFS |

| 9. Paying Unit | 10. Contractor Name and Address |

|INCIDENT BUSINESS-CONTRACTS |Blagg’s Food Service |

|ALBUQUERQUE SERVICE CENTER |21885 Highway |

|101B SUN AVENUE NE |Bella Vista, CA 96008 |

|ALBUQUERQUE, NM 87109 | |

| 11. | 12. | 13. |11. | 12. |13. |

|Meals |Serve/ |Menu and Menu Approvals |Meals |Serve/ |Menu and Menu Approvals |

|Ordered |C/I/D |Major Items & Signatures |Ordered |C/I/D |Major Items & Signatures |

| |Times* | | |Times* | |

| Breakfast | | | Sack | | |

| | | |Lunch | | |

| | | | | | |

| | | | | | | | |

| | |Government Representative |Contractor Representative | | |Government Representative |Contractor Representative |

| Cold Can | | | Dinner | | |

|Breakfast | | | | | |

| | | |600 |1800 | |

|- | | | |120i 1300 | |

| | | | |720c 1445 | |

| | | | | | | | |

| | |Government Representative |Contractor Representative | | |Government Representative |Contractor Representative |

| |

| | 14. |15. Number and Price of meals For Payment Purpose | 16. |

| |Actual Number of | |Totals |

| |Meals Served / Time | | |

| | |Meal and Prices |Price Per Meal | |

| Breakfast |-0- | |Breakfast @ Price | $ 13.25 | $ -0- |

| Cold Can Br |-0- | |Cold Can Breakfast @ Price | $ 14.25 | $ -0- |

| Sack Lunch | -0- | |Sack Lunch @ Price | $ 13.95 | $ -0- |

| Dinner |-0- |648 |Dinner @ Price | $ 19.15 | $ 12,409.20 |

|Subtotal: | $ 12,409.20 |

| |

| 17. Unit Description | 18. |19. Mileage |20. Usage / Relocation |Service | 21. |

|and Number |Location | | | |Totals |

| | |No. |Price |No. |Price/Fee | | |

|Kitchen |K-1 |From: |Redding, CA |420 mi. |

|Unit | | | | |

|22. SUPPLEMENTAL FOODS AND BEVERAGES (total from 1276-B) | $ 0 |

|23. MISCELLANEOUS CHARGES AND CREDITS (total from 1276-B) | $ 0 |

| | $ 18,994.20 |

|24. TOTAL INVOICE AMOUNT | |

|* Serve / Cancel / Increase / Decrease Times |

| |

| 25. REMARKS |

|Dinner order increased by 120 at 1300 hrs. Dinner order then cancelled by 720 at 1445. Contractor arrived at the incident on time and began preparations, however|

|they were unable to meet delivery schedule because the Government delayed selecting a location for the contractor to set-up. 90% rule applies to the number of |

|meals ordered. Beginning Odometer Reading 156580, Ending Odometer Reading 157000. |

| 26. I certify that the above mentioned services have been received | 27. I certify that this bill is correct and payment has not been received |

|(Government Representative) |(Contractor Representative) |

| Name (print / sign), Title, Work Address & Phone No. | Name (print / sign), Title & Phone No. |

|Mike Government, FDUL Mike Government (208) 387-5665 |Joe Contractor, Manager Joe Contractor (555) 783-6556 |

1276-A (1/05)

|DAILY MEAL ORDER/INVOICE | 1. Contract Number |2. Invoice Date |3. Mobile Food Service Unit ID No. |4. Invoice No. |

|MOBILE FOOD SERVICES |AG-024B-05-9017 |06/16/05 |K-1 |2 |

| | 5. Incident Name |6. Job Code | 7. Resource Order No. / Request No. |8. Benefiting Unit, Region / Agency |

| |Big Bad Fire |P6BKIB |OR-SIF-000011 E-7 |Wenatchee NF/R6/USFS |

| 9. Paying Unit | 10. Contractor Name and Address |

|INCIDENT BUSINESS-CONTRACTS |Blagg’s Food Service |

|ALBUQUERQUE SERVICE CENTER |21885 Highway |

|101B SUN AVENUE NE |Bella Vista, CA 96008 |

|ALBUQUERQUE, NM 87109 | |

| 11. | 12. | 13. |11. | 12. |13. |

|Meals |Serve/ |Menu and Menu Approvals |Meals |Serve/ |Menu and Menu Approvals |

|Ordered |C/I/D |Major Items & Signatures |Ordered |C/I/D |Major Items & Signatures |

| |Times* | | |Times* | |

| Breakfast | | | Sack | | |

| | | |Lunch | | |

|800 |0600 | |720 |0500 | |

| | | | | | | | |

| | |Government Representative |Contractor Representative | | |Government Representative |Contractor Representative |

| Cold Can | | | Dinner | | |

|Breakfast | | | | | |

| | | |800 |1700 | |

|- | | | | | |

| | | | | | | | |

| | |Government Representative |Contractor Representative | | |Government Representative |Contractor Representative |

| |

| | 14. |15. Number and Price of meals For Payment Purpose | 16. |

| |Actual Number of | |Totals |

| |Meals Served / Time | | |

| | |Meal and Prices |Price Per Meal | |

| Breakfast |715 / 0600 |720 |Breakfast @ Price | $ 13.25 | $ 9,540.00 |

| Cold Can Br |-0- | |Cold Can Breakfast @ Price | $ 14.25 | $ -0- |

| Sack Lunch | 720 / 0500 |720 |Sack Lunch @ Price | $ 13.95 | $ 10,044.00 |

| Dinner |750 / 1700 |750 |Dinner @ Price | $ 19.15 | $ 14,362.50 |

|Subtotal: | $ 33,946.00 |

| |

| 17. Unit Description | 18. |19. Mileage |20. Usage / Relocation |Service | 21. |

|and Number |Location | | | |Totals |

| | |No. |Price |No. |Price/Fee | | |

|Kitchen | |From: | | |

|Unit | | | | |

|22. SUPPLEMENTAL FOODS AND BEVERAGES (total from 1276-B) | $ 0 |

|23. MISCELLANEOUS CHARGES AND CREDITS (total from 1276-B) | $ -340.00 |

| | $ 34,206.50 |

|24. TOTAL INVOICE AMOUNT | |

|* Serve / Cancel / Increase / Decrease Times |

| |

| 25. REMARKS |

|All meals ordered 6/15 @ 1500 hrs. |

| 26. I certify that the above mentioned services have been received | 27. I certify that this bill is correct and payment has not been received |

|(Government Representative) |(Contractor Representative) |

| Name (print / sign), Title, Work Address & Phone No. | Name (print / sign), Title & Phone No. |

|Mike Government, FDUL Mike Government (208) 387-5665 |Joe Contractor, Manager Joe Contractor (555) 783-6556 |

1276-A (1/05)

DAILY MEAL ORDER/INVOICE – MOBILE FOOD SERVICES (CONTINUATION SHEET)

|28. SUPPLEMENTAL FOODS AND BEVERAGES |

|Date Ordered |Food Unit Leader |Contractor |Invoice No. |

|6/16/05 |Mike Government |Blagg’s Food Service Unit K-1 |2 |

|Item |Unit |Units |Units |Date Received |Unit |Extended |

| | |Ordered |Received |& Initials |Price |Price |

|Fruit Juices (48/case) (5-6 oz. each) |case | | | | |$ |$ |

|Milk (48/case) (8 oz. each) |case | | | | |$ |$ |

|Bottled Sports Type Drink |ounce | | | | |$ |$ |

|Brewed Coffee (outside incident dining area) |gallon | | | | |$ |$ |

|Hot Chocolate (outside incident dining area) |gallon | | | | |$ |$ |

|Tea (iced or hot) (outside incident dining area) |gallon | | | | |$ |$ |

|Bottled Water |ounce | | | | |$ |$ |

|Trail Mix |ounce | | | | |$ |$ |

|Granola Bars |ounce | | | | |$ |$ |

|Salted Peanuts |ounce | | | | |$ |$ |

|Salted Mixed Nuts |ounce | | | | |$ |$ |

|Yogurt |ounce | | | | |$ |$ |

|Fresh Apples (minimum size 100 count) |case | | | | |$ |$ |

|Fresh oranges (minimum size 88 count) |case | | | | |$ |$ |

|Fresh Whole Bananas |pound | | | | |$ |$ |

|Dried Apricots (pre-packaged) |ounce | | | | |$ |$ |

|Dried Prunes (pre-packaged) |ounce | | | | |$ |$ |

|Dried Banana Chips (pre-packaged) |ounce | | | | |$ |$ |

|Soup for 25 persons |gallon | | | | |$ |$ |

|Stew for 25 persons |gallon | | | | |$ |$ |

|Dinner Rolls (wheat and/or white) |dozen | | | | |$ |$ |

|Ice |pound | | | | |$ |$ |

|Ground Coffee |pound | | | | |$ |$ |

| | | |

| |TOTAL: |$ |

| |

|29. MISCELLANEOUS CHARGES AND CREDITS |

|Item | |Description | | |Amount |

|Optional Refer Space | |10 sq. ft. @ $2.00/sq. ft. | |$ |20.00 |

| | | | |$ | |

|W.O. #1 | |$3.00 deduction for 120 sack lunches see remarks below | |$ |-360.00 |

| | | | |$ | |

| |TOTAL: |$ | -$340.00 |

| |

| 30. REMARKS |

|Optional Refer space needed to store excess sack lunches. Gov’t. refer not available. |

| |

|120 sack lunches did not provide 2nd entrée as required. Contractor agrees to $3.00 deduction/sack lunch for this deficiency. |

| 31. I certify that the above charges and/or credits are correct. |

| Government Representative and Date 6/16/05 | Contractor Representative and date 6/16/05 |

|Mike Government, FDUL Mike Government (208) 387-5665 |Joe Contractor, Manager Joe Contractor (555) 783-6556 |

1276-B (1/05)

|DAILY MEAL ORDER/INVOICE | 1. Contract Number |2. Invoice Date |3. Mobile Food Service Unit ID No. |4. Invoice No. |

|MOBILE FOOD SERVICES |AG-024B-05-9017 |06/17/05 |K-1 |3 |

| | 5. Incident Name |6. Job Code | 7. Resource Order No. / Request No. |8. Benefiting Unit, Region / Agency |

| |Big Bad Fire |P6BKIB |OR-SIF-000011 E-7 |Wenatchee NF/R6/USFS |

| 9. Paying Unit | 10. Contractor Name and Address |

|INCIDENT BUSINESS-CONTRACTS |Blagg’s Food Service |

|ALBUQUERQUE SERVICE CENTER |21885 Highway |

|101B SUN AVENUE NE |Bella Vista, CA 96008 |

|ALBUQUERQUE, NM 87109 | |

| 11. | 12. | 13. |11. | 12. |13. |

|Meals |Serve/ |Menu and Menu Approvals |Meals |Serve/ |Menu and Menu Approvals |

|Ordered |C/I/D |Major Items & Signatures |Ordered |C/I/D |Major Items & Signatures |

| |Times* | | |Times* | |

| Breakfast | | | Sack | | |

| | | |Lunch | | |

|800 |0600 | |380 |0500 | |

| | | | | | | | |

| | |Government Representative |Contractor Representative | | |Government Representative |Contractor Representative |

| Cold Can | | | Dinner | | |

|Breakfast | | | | | |

| | | |800 |1700 | |

|- | | | | | |

| | | | | | | | |

| | |Government Representative |Contractor Representative | | |Government Representative |Contractor Representative |

| |

| | 14. |15. Number and Price of meals For Payment Purpose | 16. |

| |Actual Number of | |Totals |

| |Meals Served / Time | | |

| | |Meal and Prices |Price Per Meal | |

| Breakfast |725 / 0600 |725 |Breakfast @ Price | $ 13.25 | $ 9,606.25 |

| Cold Can Br |-0- | |Cold Can Breakfast @ Price | $ 14.25 | $ -0- |

| Sack Lunch |380 / 0500 |380 |Sack Lunch @ Price | $ 13.95 | $ 5,301.00 |

| Dinner |700 / 1700 |720 |Dinner @ Price | $ 19.15 | $ 13,788.00 |

|Subtotal: | $ 28,695.25 |

| |

| 17. Unit Description | 18. |19. Mileage |20. Usage / Relocation |Service | 21. |

|and Number |Location | | | |Totals |

| | |No. |Price |No. |Price/Fee | | |

|Kitchen | |From: | | |

|Unit | | | | |

|22. SUPPLEMENTAL FOODS AND BEVERAGES (total from 1276-B) | $ 211.20 |

|23. MISCELLANEOUS CHARGES AND CREDITS (total from 1276-B) | $ |

| | $ 29,506.45 |

|24. TOTAL INVOICE AMOUNT | |

|* Serve / Cancel / Increase / Decrease Times |

| |

| 25. REMARKS |

|All meals ordered 6/15 @ 1500 hrs. |

| 26. I certify that the above mentioned services have been received | 27. I certify that this bill is correct and payment has not been received |

|(Government Representative) |(Contractor Representative) |

| Name (print / sign), Title, Work Address & Phone No. | Name (print / sign), Title & Phone No. |

|Mike Government, FDUL Mike Government (208) 387-5665 |Joe Contractor, Manager Joe Contractor (555) 783-6556 |

1276-A (1/05)

DAILY MEAL ORDER/INVOICE – MOBILE FOOD SERVICES (CONTINUATION SHEET)

|28. SUPPLEMENTAL FOODS AND BEVERAGES |

|Date Ordered |Food Unit Leader |Contractor |Invoice No. |

|6/17/05 |Mike Government |Blagg’s Food Service Unit K-1 |3 |

|Item |Unit |Units |Units |Date Received |Unit |Extended |

| | |Ordered |Received |& Initials |Price |Price |

|Fruit Juices (48/case) (5-6 oz. each) |case | | | | |$ |$ |

|Milk (48/case) (8 oz. each) |case | | | | |$ |$ |

|Bottled Sports Type Drink |ounce | | | | |$ |$ |

|Brewed Coffee (outside incident dining area) |gallon | | | | |$ |$ |

|Hot Chocolate (outside incident dining area) |gallon | | | | |$ |$ |

|Tea (iced or hot) (outside incident dining area) |gallon | | | | |$ |$ |

|Bottled Water |ounce |4000 |4224 |6/17/05 |MG |$ .05 |$ 211.20 |

|Trail Mix |ounce | | | | |$ |$ |

|Granola Bars |ounce | | | | |$ |$ |

|Salted Peanuts |ounce | | | | |$ |$ |

|Salted Mixed Nuts |ounce | | | | |$ |$ |

|Yogurt |ounce | | | | |$ |$ |

|Fresh Apples (minimum size 100 count) |case | | | | |$ |$ |

|Fresh oranges (minimum size 88 count) |case | | | | |$ |$ |

|Fresh Whole Bananas |pound | | | | |$ |$ |

|Dried Apricots (pre-packaged) |ounce | | | | |$ |$ |

|Dried Prunes (pre-packaged) |ounce | | | | |$ |$ |

|Dried Banana Chips (pre-packaged) |ounce | | | | |$ |$ |

|Soup for 25 persons |gallon | | | | |$ |$ |

|Stew for 25 persons |gallon | | | | |$ |$ |

|Dinner Rolls (wheat and/or white) |dozen | | | | |$ |$ |

|Ice |pound | | | | |$ |$ |

|Ground Coffee |pound | | | | |$ |$ |

| | | |

| |TOTAL: |$ 211.20 |

| |

|29. MISCELLANEOUS CHARGES AND CREDITS |

|Item | |Description | | |Amount |

| | | | |$ | |

| | | | |$ | |

| | | | |$ | |

| | | | |$ | |

| |TOTAL: |$ | |

| |

| 30. REMARKS |

|Bottled water was purchased by the case. 11 cases were delivered. Each case contained 24 each 16 oz. bottles for a total of 4,224 oz. delivered. |

| |

| |

| 31. I certify that the above charges and/or credits are correct. |

| Government Representative and Date 6/17/05 | Contractor Representative and date 6/17/05 |

|Mike Government, FDUL Mike Government (208) 387-5665 |Joe Contractor, Manager Joe Contractor (555) 783-6556 |

1276-B (1/05)

|DAILY MEAL ORDER/INVOICE | 1. Contract Number |2. Invoice Date |3. Mobile Food Service Unit ID No. |4. Invoice No. |

|MOBILE FOOD SERVICES |AG-024B-05-9017 |06/18/05 |K-1 |4 |

| | 5. Incident Name |6. Job Code | 7. Resource Order No. / Request No. |8. Benefiting Unit, Region / Agency |

| |Big Bad Fire |P6BKIB |OR-SIF-000011 E-7 |Wenatchee NF/R6/USFS |

| 9. Paying Unit | 10. Contractor Name and Address |

|INCIDENT BUSINESS-CONTRACTS |Blagg’s Food Service |

|ALBUQUERQUE SERVICE CENTER |21885 Highway |

|101B SUN AVENUE NE |Bella Vista, CA 96008 |

|ALBUQUERQUE, NM 87109 | |

| 11. | 12. | 13. |11. | 12. |13. |

|Meals |Serve/ |Menu and Menu Approvals |Meals |Serve/ |Menu and Menu Approvals |

|Ordered |C/I/D |Major Items & Signatures |Ordered |C/I/D |Major Items & Signatures |

| |Times* | | |Times* | |

| Breakfast | | | Sack | | |

| | | |Lunch | | |

|800 |0600 | | | | |

| | | | | | | | |

| | |Government Representative |Contractor Representative | | |Government Representative |Contractor Representative |

| Cold Can | | | Dinner | | |

|Breakfast | | | | | |

| | | | | | |

|- | | | | | |

| | | | | | | | |

| | |Government Representative |Contractor Representative | | |Government Representative |Contractor Representative |

| |

| | 14. |15. Number and Price of meals For Payment Purpose | 16. |

| |Actual Number of | |Totals |

| |Meals Served / Time | | |

| | |Meal and Prices |Price Per Meal | |

| Breakfast |650/ 0600 |720 |Breakfast @ Price | $ 13.25 | $ 9,540.00 |

| Cold Can Br |-0- | |Cold Can Breakfast @ Price | $ 14.25 | $ -0- |

| Sack Lunch |-0- | |Sack Lunch @ Price | $ 13.95 | $ -0- |

| Dinner |-0- | |Dinner @ Price | $ 19.15 | $ -0- |

|Subtotal: | $ 9,540.00 |

| |

| 17. Unit Description | 18. |19. Mileage |20. Usage / Relocation |Service | 21. |

|and Number |Location | | | |Totals |

| | |No. |Price |No. |Price/Fee | | |

|Kitchen | K-1 |From: |Wenatchee, WA |420 |

|Unit | | | | |

|22. SUPPLEMENTAL FOODS AND BEVERAGES (total from 1276-B) | $ |

|23. MISCELLANEOUS CHARGES AND CREDITS (total from 1276-B) | $ |

| | $ 16,125.00 |

|24. TOTAL INVOICE AMOUNT | |

|* Serve / Cancel / Increase / Decrease Times |

| |

| 25. REMARKS |

|All meals ordered 6/17 @ 1500 hrs. |

|Released kitchen @ 0900 hrs. |

| 26. I certify that the above mentioned services have been received | 27. I certify that this bill is correct and payment has not been received |

|(Government Representative) |(Contractor Representative) |

| Name (print / sign), Title, Work Address & Phone No. | Name (print / sign), Title & Phone No. |

|Mike Government, FDUL Mike Government (208) 387-5665 |Joe Contractor, Manager Joe Contractor (555) 783-6556 |

1276-A (1/05)

| |1. Paying Unit |2. Contractor Name, Address |3. Contractor Number |4. Invoice Date |5. Shower ID No. |6. Invoice No. |

|DAILY SHOWER | | | | | | |

|ORDER/INVOICE | | | | | | |

|MOBILE SHOWER | | | | | | |

|FACILITIES | | | | | | |

| | INCIDENT BUSINESS-CONTRACTS |Action Sanitary | 53-024B-4-2405 | 06 /15/05 |S-1 |1 |

| |ALBUQUERQUE SERVICE CENTER | | | | | |

| |101B SUN AVENUE NE | | | | | |

| |ALBUQUERQUE, NM 87109 | | | | | |

| | |P.O. Box 492 |7. Incident Name |8. Job Code |9. Resource Order |

| | |Lower Lake, CA 95457 |Big Bad Fire |P6BKIB |OR-SIF-000011 |

| | |TIN: |10. Benefiting Unit, Region/Agency |Request No. |

| | |DUNS: |Wenatchee NF/R6/USFS |E-8 |

|SHOWER FACILITIES UNIT DISPATCHED BY THE GOVERNMENT TO AN INCIDENT |

|11. Unit |12. |13. |14. |15. |16. |17. *Transportation |

| | | |Mileage |Usage |Relocation |H2O |

| | | | | |Fee | |

|OPTIONAL EQUIPMENT DISPATCHED BY GOVERNMENT TO AN INCIDENT | | | | | | |

|Unit | | |Mileage |Usage |Relocation |Transportati|Intermittent Use |

| | | | | |Fee |on H2O | |

| | |

|Block #13 Beginning Odometer Reading 185549 |Names (print and sign), Title, Work Address and Phone |

|Ending Odometer Reading 186450 | |

|1 hour intermittent use ordered to provide potable water to kitchen unit. |Mike Government, FDUL Mike Government (208) 387-5665 |

| |123 Roadway |

|Shower Unit operational at 1630 hrs. However, Government delayed selection of site location for set-up. Payment for |Boise, ID 8370 |

|Shower Unit will begin at time of arrival to the incident (1300 Hrs.) per Section G.2 2.4. | |

| |24. I certify this bill is correct and payment has not been received (Contractor Representative) |

| |Name (print and sign), Title and Phone |

| |Jane Contractor, Shower Manager Jane Contractor |

| |(123) 456-7890 |

1276-C (2/2004)

| |

| |

| |

| |

|DAILY SHOWER ORDER/INVOICE – MOBILE SHOWER FACILITIES (CONTINUATION SHEET) |

|Date |Government Representative |Contractor |Invoice No. |

|6/15/05 |Mike Government, FDUL Mike Government (208) 387-5665 |Action Sanitary S-1 |1 |

| |25. TRANSPORTING WATER |26. INTERMITTENT USE |

|Unit |Name of |Odometer | |Time | |

| | | |TOTAL | |TOTAL TIME |

| | | |MILES | | |

|ID |Locations |Readings | |(Military) | |

| No. * |

| | | | | | |

| | | | | | |

|28. I certify the charges and/or credits are correct. |I certify the charges and/or credits are correct. |

| | | | | | | |

| | INCIDENT BUSINESS-CONTRACTS |Action Sanitary | 53-024B-4-2405 |6/18/05 |S-1 |4 |

| |ALBUQUERQUE SERVICE CENTER | | | | | |

| |101B SUN AVENUE NE | | | | | |

| |ALBUQUERQUE, NM 87109 | | | | | |

| | |P.O. Box 492 |7. Incident Name |8. Job Code |9. Resource Order |

| | |Lower Lake, CA 95457 |Big Bad Fire |P6BKIB |OR-SIF-000011 |

| | |TIN: |10. Benefiting Unit, Region/Agency |Request No. |

| | |DUNS: |Wenatchee NF/R6/USFS |E-8 |

|SHOWER FACILITIES UNIT DISPATCHED BY THE GOVERNMENT TO AN INCIDENT |

|11. Unit |12. |13. |14. |15. |16. |17. *Transportation |

| | | |Mileage |Usage |Relocation |H2O |

| | | | | |Fee | |

|OPTIONAL EQUIPMENT DISPATCHED BY GOVERNMENT TO AN INCIDENT | | | | | | |

|Unit | | |Mileage |Usage |Relocation |Transportati|Intermittent Use |

| | | | | |Fee |on H2O | |

| | |

|Block #13 Beginning Odometer Reading 186450 |Mike Government, FDUL Mike Government (208) 387-5665 |

|Ending Odometer Reading 187360 | |

| |123 Roadway |

| |Boise, ID 8370 |

|Released at 1030 hrs. | |

| |24. I certify this bill is correct and payment has not been received (Contractor Representative) |

| |Name (print and sign), Title and Phone |

| |Jane Contractor, Shower Manager Jane Contractor |

| |(123) 456-7890 |

1276-C (2/2004)

| |

| |

| |

|DAILY SHOWER ORDER/INVOICE – MOBILE SHOWER FACILITIES (CONTINUATION SHEET) |

|Date |Government Representative |Contractor |Invoice No. |

|6/18/05 |Mike Government, FDUL Mike Government (208) 387-5665 |Action Sanitary S-1 |4 |

| |25. TRANSPORTING WATER |26. INTERMITTENT USE |

|Unit |Name of |Odometer | |Time | |

| | | |TOTAL | |TOTAL TIME |

| | | |MILES | | |

|ID |Locations |Readings | |(Military) | |

| No. * |

| | | | | | |

| | | | | | |

|28. I certify the charges and/or credits are correct. |I certify the charges and/or credits are correct. |

| | | | | | | | | | | | | | | | | | | | | | |6/17/05 | |JaneContractor | | |6/17/05 | |Mike Government | | | |Date | |Contractor | | |Date | |Government Representative | | | | | | | | | | | | | |

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